STRESS RELATED DISORDERS
In 2013, the American Psychiatric Association released the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). The DSM-5 reorganized trauma- and stressor-related disorders into a new category. Changes were made to differentiate these disorders from anxiety disorders as well as restructure and modify various factors and symptoms (Jones & Cureton, 2014). Posttraumatic stress disorder (PTSD) and acute stress disorder (ASD) were formerly categorized as anxiety disorders but are now included as trauma- and stressor-related disorders. This category reconceptualizes various diagnoses as stress-response syndromes in reaction to specific triggering events (Kurtz, 2013). The diagnoses now included in the trauma- and stressor-related disorder category are:
Post-traumatic stress disorder (PTSD). Children and adolescents with PTSD have symptoms such as persistent, frightening thoughts and memories or flashbacks of a traumatic event or events. Other symptoms may include jumpiness, sleep problems, problems in school, avoidance of certain places or situations, depression, headaches or stomach pains.
Acute stress disorder (ASD). The symptoms of ASD are similar to PTSD, but occur within the first month after exposure to trauma. Prompt treatment and appropriate social support can reduce the risk of ASD developing into PTSD.
Adjustment disorders. Adjustment disorders are unhealthy or unhelpful reactions to stressful events or changes in a child’s life. These reactions can be emotional, such as a depressed mood or nervousness, or behavioral, such as misconduct or violating the rights of others.
Reactive attachment disorder (RAD). Children with RAD show limited emotional responses in situations where those are ordinarily expected. This might show in a lack of remorse after bad behavior or a lack of response to positive or negative emotional triggers. Children with RAD may not appear to want or need comfort from caregivers. They may not seem to care when toy is taken away from them.
Disinhibited social engagement disorder (DSED). Children with DSED are unusually open to interactions with strangers. They can be over-eager to form attachments with others, walking up to and even hugging strangers. They may wander off with strangers without checking with their parent or caregiver.
Unclassified and unspecified trauma disorders. Some emotional and behavioral reactions to trauma do not fit in the diagnostic categories above. This category is used for those cases.
Childhood stress and trauma can have health and life impacts beyond these five types of emotional disorders. Research into the effects of adverse childhood experiences (ACEs), begun with a study conducted at Kaiser Permanente with the Centers for Disease Control in the 1990s and subsequently expanded with additional data, has shown a direct relationship between ACEs and a wide range of negative outcomes later in life.
The adverse experiences considered in these studies include:
· Physical, sexual or emotional abuse
· Physical or emotional neglect
· Household violence, substance abuse or mental illness
· Parental separation or divorce
· Incarceration of a family member
Stress-related disorders include mental health disorders that develop as a result of anxiety-related issues due to physical, mental, or emotional health problems. Some of the most common stress-related illnesses include post-traumatic stress disorder (PTSD) and obsessive-compulsive disorder (OCD).
Stress is the result of a conscious or unconscious feeling or thought resulting from a traumatic event or pressures placed upon a person mentally or physically. In this case, the pressure placed on the individual may seem, to them, to exceed their physical or mental capabilities. A person may become stressed if they feel threatened, harmed, or challenged by someone else. However, stress has a significant impact on a person's physical and mental health.
The way stress is experienced is very unique and particular to the individual. Stress depends on the overall implications and triggering effects a certain situation may place on a person. This can either be the result of physical experiences or be genetic. In cases of both acute and chronic stress-related disorders, the morbidity rate of the individual increases exponentially - especially in cases of prolonged stress and anxiety.
There are five common stress-related disorders.
Reactive attachment disorder is defined by an inability to express emotional or physical attachment to others. In children, symptoms may include a disinterest in physical or emotional comfort when distressed or a lack of responsive emotions. At times, this is a result of neglect and lack of proper caregiving in order for the child to develop relationships. In adults, these symptoms may increase and hinder them from forming close relationships and potentially lead to other mental illnesses.
Disinhibited social engagement disorder is a stress-related disorder characterized by behavior deemed culturally and socially inappropriate. This can include inappropriate behavior, oversharing intimate information, or close, physical familiarity with strangers.
Post-traumatic stress disorder is the result of past traumatic events significantly impacting the person's mental health. This is often the result of reliving, remembering, or having nightmares associated with past trauma.
Acute stress disorder or episodic acute distress order is similar in effect to PTSD, but typically holds a shorter duration following the stressful situation.
Adjustment disorder is a disorder that presents itself with symptoms with an identifiable cause. These may include work-related stressors, moving to a different state, environmental or lifestyle changes, or educational shifts. Adjustment disorder is typically a short-term experience and changes as the person becomes more comfortable with the change.
Symptoms of Stress Disorders
Stress disorder symptoms commonly manifest themselves in four different categories.